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目的探讨三维超声造影在乳腺肿块鉴别诊断中的应用价值。方法回顾性收集2013年7月到2016年2月期间于笔者所在医院诊治并经手术病理学检查证实乳腺肿块性质的120例患者,其中包括良性患者70例(良性组)与恶性患者50例(恶性组),所有患者均接受常规二维超声与三维超声造影检查,比较良性组和恶性组患者的影像学特征,并比较二维超声与三维超声造影对乳腺肿块的诊断价值。结果与良性组相比,恶性组的各项二维超声特征,包括肿块形态不规则、边界不清晰、内部回声不均匀、微钙化、侧方声影及回声衰减的比例均较高(P<0.05)。恶性组与良性组的三维超声造影评分比较差异有统计学意义(P<0.05),恶性组的得分较高,良性组的评分多为2、3分,而恶性组多为4、5分。二维超声和三维超声造影诊断乳腺肿块的灵敏度分别为97.1%(68/70)和98.6%(69/70),特异度分别为80.0%(40/50)和96.0%(48/50),三维超声造影的特异度高于二维超声(P<0.05)。结论二维超声与三维超声造影对乳腺肿块均有一定的诊断价值,而三维超声造影能够通过评估肿瘤组织微血管的丰富程度以获得更多的信息,从而提高了诊断特异度,值得推广应用。
Objective To investigate the value of three-dimensional contrast-enhanced ultrasound in the differential diagnosis of breast masses. Methods Retrospectively collected 120 patients diagnosed with breast lump in our hospital from July 2013 to February 2016, including 70 benign patients (benign group) and 50 malignant patients (benign group) Malignant group), all patients underwent conventional two-dimensional ultrasound and three-dimensional contrast echocardiography, and compared the imaging features of benign and malignant group, and compared the diagnostic value of two-dimensional ultrasound and three-dimensional contrast-enhanced ultrasound in the diagnosis of breast masses. Results Compared with the benign group, the two-dimensional ultrasonographic features of the malignant group, including the irregular shape of the tumor, the unclear boundary, the uneven internal echo, the micro-calcification, lateral acoustic shadow and echo attenuation, were all significantly higher (P < 0.05). There was significant difference between the malignant group and the benign group in three-dimensional contrast-enhanced ultrasound (P <0.05). The score of the malignant group was higher than that of the benign group (2,3 points). The sensitivity of two-dimensional and three-dimensional contrast-enhanced ultrasound in the diagnosis of breast masses were 97.1% (68/70) and 98.6% (69/70) respectively, and the specificity were 80.0% (40/50) and 96.0% (48/50) Three-dimensional contrast-enhanced ultrasound was more specific than two-dimensional ultrasound (P <0.05). Conclusion Two-dimensional ultrasound and three-dimensional contrast-enhanced ultrasound have certain diagnostic value for breast masses. However, three-dimensional contrast-enhanced ultrasound can obtain more information by evaluating the abundance of microvessels in the tumor tissue, which enhances the diagnostic specificity and is worthy of popularization and application.